Christensen Helle Marie, Huniche Lotte
Department of Respiratory Medicine, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
Department of Psychology, University of Southern Denmark, Odense, Denmark.
SAGE Open Med. 2020 May 6;8:2050312120918996. doi: 10.1177/2050312120918996. eCollection 2020.
Lung cancer is one of the most common types of cancer, with high mortality rate and a significant burden of symptoms. It is therefore important to assess patients' perceived quality of life during the diagnostic process and treatment. Knowledge of and attention to patients' perspectives, experiences, and expectations in relation to lung cancer diagnostic pathways is limited. The aim of the study is to contribute with patients' and relatives' experiences with and their assessment of the quality of a hospital-based lung cancer diagnostic pathway.
A qualitative study was conducted, comprising participant observation with 20 patients and semi-structured interviews with further 19 patients referred to the Lung Cancer Package, which initiates a fast track diagnostic pathway in a hospital setting. Data were obtained over a period of 9 months and analysed in collaboration with an interdisciplinary team of health professionals. The purpose was to further develop existing management strategies of the fast track diagnostic pathway based on patient's perspectives.
Patients associated the fast track diagnostic pathway with high levels of anxiety due to the immediate risk of a lung cancer diagnosis. Although patients experienced the fast track programme as very challenging, they still wanted to move through the diagnostic pathway as quickly as possible. The patients expressed a need for support from relatives and repeatedly required information in multiple formats from health professionals throughout the diagnostic pathway.
The study provided insight into the need for developing the fast track diagnostic pathway with a focus on patient anxiety, network involvement, and information strategies. The results qualified clinical practice with an increased focus on managing patients' anxiety, raised awareness to involve relatives in the diagnostic process, and relaying information in dialogue with patients and their relatives, including management strategies to support patients through diagnostic investigations in the fast track programme.
肺癌是最常见的癌症类型之一，死亡率高，症状负担重。因此，在诊断过程和治疗期间评估患者的感知生活质量很重要。关于患者对肺癌诊断途径的观点、经历和期望的了解和关注有限。本研究的目的是贡献患者及其亲属对基于医院的肺癌诊断途径的体验及其对该途径质量的评估。
进行了一项定性研究，包括对20名患者的参与观察以及对另外19名转诊至肺癌套餐（该套餐在医院环境中启动快速诊断途径）的患者进行半结构化访谈。数据在9个月的时间内收集，并与跨学科的卫生专业人员团队合作进行分析。目的是基于患者的观点进一步制定快速诊断途径的现有管理策略。
由于肺癌诊断的直接风险，患者将快速诊断途径与高度焦虑联系在一起。尽管患者认为快速诊断计划极具挑战性，但他们仍希望尽快完成诊断途径。患者表示需要亲属的支持，并在整个诊断途径中反复要求卫生专业人员以多种形式提供信息。
该研究深入了解了开发快速诊断途径的必要性，重点关注患者焦虑、网络参与和信息策略。研究结果使临床实践更加注重管理患者的焦虑，提高了让亲属参与诊断过程的意识，并在与患者及其亲属的对话中传递信息，包括在快速诊断计划中通过诊断检查支持患者的管理策略。
